Individual
DAVID CLARK MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
125 RIVERSTONE TER, CANTON, GA 30114-5218
(770) 479-0472
(770) 479-0472
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
(800) 944-9782
(610) 438-2046
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0020014
GA
Other
Enumeration date
12/05/2012
Last updated
12/05/2012
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